Quintel, Michael I.

[["dc.bibliographiccitation.firstpage","413"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","Critical Care Clinics"],["dc.bibliographiccitation.lastpage","422"],["dc.bibliographiccitation.volume","34"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Vasques, Francesco"],["dc.contributor.author","Duscio, Eleonora"],["dc.contributor.author","Cipulli, Francesco"],["dc.contributor.author","Romitti, Federica"],["dc.contributor.author","Gattinoni, Luciano"],["dc.contributor.author","Quintel, Michael"],["dc.date.accessioned","2020-12-10T14:22:56Z"],["dc.date.available","2020-12-10T14:22:56Z"],["dc.date.issued","2018"],["dc.identifier.doi","10.1016/j.ccc.2018.03.011"],["dc.identifier.issn","0749-0704"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/71782"],["dc.language.iso","en"],["dc.notes.intern","DOI Import GROB-354"],["dc.title","Extracorporeal Gas Exchange"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","252"],["dc.bibliographiccitation.issue","2"],["dc.bibliographiccitation.journal","Critical Care Medicine"],["dc.bibliographiccitation.lastpage","264"],["dc.bibliographiccitation.volume","42"],["dc.contributor.author","Chiumello, Davide"],["dc.contributor.author","Cressoni, Massimo"],["dc.contributor.author","Carlesso, Eleonora"],["dc.contributor.author","Caspani, Maria L."],["dc.contributor.author","Marino, Antonella"],["dc.contributor.author","Gallazzi, Elisabetta"],["dc.contributor.author","Caironi, Pietro"],["dc.contributor.author","Lazzerini, Marco"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Gattinoni, Luciano"],["dc.date.accessioned","2018-11-07T09:44:43Z"],["dc.date.available","2018-11-07T09:44:43Z"],["dc.date.issued","2014"],["dc.description.abstract","Objective: Positive end-expiratory pressure exerts its effects keeping open at end-expiration previously collapsed areas of the lung; consequently, higher positive end-expiratory pressure should be limited to patients with high recruitability. We aimed to determine which bedside method would provide positive end-expiratory pressure better related to lung recruitability. Design: Prospective study performed between 2008 and 2011. Setting: Two university hospitals (Italy and Germany). Patients: Fifty-one patients with acute respiratory distress syndrome. Interventions: Whole lung CT scans were taken in static conditions at 5 and 45 cm H2O during an end-expiratory/end-inspiratory pause to measure lung recruitability. To select individual positive end-expiratory pressure, we applied bedside methods based on lung mechanics (ExPress, stress index), esophageal pressure, and oxygenation (higher positive end-expiratory pressure table of lung open ventilation study). Measurements and Main Results: Patients were classified in mild, moderate and severe acute respiratory distress syndrome. Positive end-expiratory pressure levels selected by the ExPress, stress index, and absolute esophageal pressures methods were unrelated with lung recruitability, whereas positive end-expiratory pressure levels selected by the lung open ventilation method showed a weak relationship with lung recruitability (r(2) = 0.29; p < 0.0001). When patients were classified according to the acute respiratory distress syndrome Berlin definition, the lung open ventilation method was the only one which gave lower positive end-expiratory pressure levels in mild and moderate acute respiratory distress syndrome compared with severe acute respiratory distress syndrome (8 2 and 11 +/- 3 cm H2O vs 15 +/- 3 cm H2O; p < 0.05), whereas ExPress, stress index, and esophageal pressure methods gave similar positive end-expiratory pressure values in mild, moderate, and severe acute respiratory distress syndrome. The positive end-expiratory pressure selected by the different methods were unrelated to each other with the exception of the two methods based on lung mechanics (ExPress and stress index). Conclusions: Bedside positive end-expiratory pressure selection methods based on lung mechanics or absolute esophageal pressures provide positive end-expiratory pressure levels unrelated to lung recruitability and similar in mild, moderate, and severe acute respiratory distress syndrome, whereas the oxygenation-based method provided positive end-expiratory pressure levels related with lung recruitability progressively increasing from mild to moderate and severe acute respiratory distress syndrome."],["dc.identifier.doi","10.1097/CCM.0b013e3182a6384f"],["dc.identifier.isi","000329863400020"],["dc.identifier.pmid","24196193"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/34453"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Lippincott Williams & Wilkins"],["dc.relation.issn","1530-0293"],["dc.relation.issn","0090-3493"],["dc.title","Bedside Selection of Positive End-Expiratory Pressure in Mild, Moderate, and Severe Acute Respiratory Distress Syndrome"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","36"],["dc.bibliographiccitation.journal","CRITICAL CARE"],["dc.bibliographiccitation.volume","20"],["dc.contributor.author","Fanelli, Vito"],["dc.contributor.author","Ranieri, Marco V."],["dc.contributor.author","Mancebo, Jordi"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Morley, Scott"],["dc.contributor.author","Moran, Indalecio"],["dc.contributor.author","Parrilla, Francisco"],["dc.contributor.author","Costamagna, Andrea"],["dc.contributor.author","Gaudiosi, Marco"],["dc.contributor.author","Combes, Alain"],["dc.date.accessioned","2018-11-07T10:18:16Z"],["dc.date.available","2018-11-07T10:18:16Z"],["dc.date.issued","2016"],["dc.description.abstract","Background: Mechanical ventilation with a tidal volume (V-T) of 6 mL/kg/predicted body weight (PBW), to maintain plateau pressure (P-plat) lower than 30 cmH(2)O, does not completely avoid the risk of ventilator induced lung injury (VILI). The aim of this study was to evaluate safety and feasibility of a ventilation strategy consisting of very low VT combined with extracorporeal carbon dioxide removal (ECCO2R). Methods: In fifteen patients with moderate ARDS, VT was reduced from baseline to 4 mL/kg PBW while PEEP was increased to target a plateau pressure - (Pplat) between 23 and 25 cmH(2)O. Low-flow ECCO2R was initiated when respiratory acidosis developed (pH < 7.25, PaCO2 > 60 mmHg). Ventilation parameters (VT, respiratory rate, PEEP), respiratory compliance (C-RS), driving pressure (DeltaP = V-T/C-RS), arterial blood gases, and ECCO2R system operational characteristics were collected during the period of ultra-protective ventilation. Patients were weaned from ECCO2R when PaO2/FiO(2) was higher than 200 and could tolerate conventional ventilation settings. Complications, mortality at day 28, need for prone positioning and extracorporeal membrane oxygenation, and data on weaning from both MV and ECCO2R were also collected. Results: During the 2 h run in phase, VT reduction from baseline (6.2 mL/kg PBW) to approximately 4 mL/kg PBW caused respiratory acidosis (pH < 7.25) in all fifteen patients. At steady state, ECCO2R with an average blood flow of 435 mL/min and sweep gas flow of 10 L/min was effective at correcting pH and PaCO2 to within 10 % of baseline values. PEEP values tended to increase at V-T of 4 mL/kg from 12.2 to 14.5 cmH(2)O, but this change was not statistically significant. Driving pressure was significantly reduced during the first two days compared to baseline (from 13.9 to 11.6 cmH(2)O; p < 0.05) and there were no significant differences in the values of respiratory system compliance. Rescue therapies for life threatening hypoxemia such as prone position and ECMO were necessary in four and two patients, respectively. Only two study-related adverse events were observed (intravascular hemolysis and femoral catheter kinking). Conclusions: The low-flow ECCO2R system safely facilitates a low volume, low pressure ultra-protective mechanical ventilation strategy in patients with moderate ARDS."],["dc.description.sponsorship","ALung Technologies, Inc."],["dc.identifier.doi","10.1186/s13054-016-1211-y"],["dc.identifier.isi","000369912900002"],["dc.identifier.pmid","26861596"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/13484"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/41401"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1364-8535"],["dc.relation.issn","1466-609X"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress sindrome"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","1020"],["dc.bibliographiccitation.issue","7"],["dc.bibliographiccitation.journal","Journal of Clinical Medicine"],["dc.bibliographiccitation.volume","8"],["dc.contributor.author","Harnisch, Lars-Olav"],["dc.contributor.author","Riech, Sebastian"],["dc.contributor.author","Mueller, Marion"],["dc.contributor.author","Gramueller, Vanessa"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Moerer, Onnen"],["dc.date.accessioned","2019-07-16T09:02:51Z"],["dc.date.available","2019-07-16T09:02:51Z"],["dc.date.issued","2019"],["dc.description.abstract","Neurologic complications following acute respiratory distress syndrome (ARDS) are well described, however, information on the neurologic outcome regarding peripheral nervous system complications in critically ill ARDS patients, especially those who received extracorporeal membrane oxygenation (ECMO) are lacking. In this prospective observational study 28 ARDS patients who survived after ECMO or conventional nonECMO treatment were examined for neurological findings. Nine patients had findings related to cranial nerve innervation, which di ered between ECMO and nonECMO patients (p = 0.031). ECMO patients had severely increased patella tendon reflex (PTR) reflex levels (p = 0.027 vs. p = 0.125) as well as gastrocnemius tendon reflex (GTR) (p = 0.041 right, p = 0.149 left) were a ected on the right, but not on the left side presumably associated with ECMO cannulation. Paresis (14.3% of patients) was only found in the ECMO group (p = 0.067). Paresthesia was frequent (nonECMO 53.8%, ECMO 62.5%; p = 0.064), in nonECMO most frequently due to initial trauma and polyneuropathy, in the ECMO group mainly due to impairments of N. cutaneus femoris lateralis (4 vs. 0; p = 0.031). Besides well-known central neurologic complications, more subtle complications were detected by thorough clinical examination. These findings are su cient to hamper activities of daily living and impair quality of life and psychological health and are presumably directly related to ECMO therapy."],["dc.identifier.doi","10.3390/jcm8071020"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/16283"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/61555"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.publisher","MDPI"],["dc.relation.eissn","2077-0383"],["dc.relation.issn","2077-0383"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Longtime Neurologic Outcome of Extracorporeal Membrane Oxygenation and Non Extracorporeal Membrane Oxygenation Acute Respiratory Distress Syndrome Survivors"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","33"],["dc.bibliographiccitation.journal","Annals of Clinical Microbiology and Antimicrobials"],["dc.bibliographiccitation.volume","14"],["dc.contributor.author","Kunze, Nils"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Steinmetz, Nicolas"],["dc.contributor.author","Schulze, M. H."],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Perl, Thorsten"],["dc.date.accessioned","2018-11-07T09:55:53Z"],["dc.date.available","2018-11-07T09:55:53Z"],["dc.date.issued","2015"],["dc.description.abstract","Background: The early beginning of an adequate antibiotic therapy is crucial in hospital-acquired pneumonia (HAP), but depends on the results of conventional microbiological diagnostics (cMD). It was the aim of this study to evaluate the performance and turnaround times of a new point-of-care multiplex polymerase chain reaction (mPCR) system for rapid identification of pathogens and antibiotic resistance markers. We assessed the applicability of the system under real-life conditions in critical ill patients with HAP. Methods: We enrolled forty critical ill patients with clinical signs for HAP into an observational study. Two samples of respiratory secretions were collected during one course of aspiration and cMD and mPCR testing (Unyvero, Curetis AG, Holzgerlingen, Germany) were performed immediately. The mPCR device was operated as a point-of-care system at the intensive care unit. We compared turnaround times, results of pathogen identification and results of antibiotic resistance testing of both methods. Results: Mean turnaround times (min-max) were 6.5 h (4.7-18.3 h) for multiplex PCR and 71 h (37.2-217.8 h) for conventional microbiology (final cMD results, incomplete results neglected). 60 % (n = 24) of the mPCR tests were completely valid. Complete test failure occurred in 10 % (n = 4) and partial test failure occurred in 30 % (n = 12). We found concordant results in 45 % (n = 18) and non-concordant results in 45 % (n = 18) of all patients. 55 % (n = 16) of the results were concordant in patients with a clinical pulmonary infection score (CPIS) > 5 (n = 29). Concordant results included three cases of multidrug resistant bacteria. MPCR frequently detected antibiotic resistance markers that were not found by cMD. Conclusions: Unyvero allowed point-of-care microbial testing with short turnaround times. The performance of the system was poor. However, an improved system with a more reliable performance and an extended microbial panel could be a useful addition to cMD in intensive care medicine."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2015"],["dc.identifier.doi","10.1186/s12941-015-0091-3"],["dc.identifier.isi","000356592600001"],["dc.identifier.pmid","26071191"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/13460"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/36848"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1476-0711"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Point-of-care multiplex PCR promises short turnaround times for microbial testing in hospital-acquired pneumonia - an observational pilot study in critical ill patients"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","699"],["dc.bibliographiccitation.issue","5"],["dc.bibliographiccitation.journal","Intensive Care Medicine"],["dc.bibliographiccitation.lastpage","711"],["dc.bibliographiccitation.volume","42"],["dc.contributor.author","Bein, Thomas"],["dc.contributor.author","Grasso, Salvatore"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Guerin, Claude"],["dc.contributor.author","Deja, Maria"],["dc.contributor.author","Brondani, Anita"],["dc.contributor.author","Mehta, Sangeeta"],["dc.date.accessioned","2018-11-07T10:15:16Z"],["dc.date.available","2018-11-07T10:15:16Z"],["dc.date.issued","2016"],["dc.description.abstract","Severe ARDS is often associated with refractory hypoxemia, and early identification and treatment of hypoxemia is mandatory. For the management of severe ARDS ventilator settings, positioning therapy, infection control, and supportive measures are essential to improve survival. A precise definition of life-threating hypoxemia is not identified. Typical clinical determinations are: arterial partial pressure of oxygen < 60 mmHg and/or arterial oxygenation < 88 % and/or the ratio of PaO2/FIO2 < 100. For mechanical ventilation specific settings are recommended: limitation of tidal volume (6 ml/kg predicted body weight), adequate high PEEP (> 12 cmH(2)O), a recruitment manoeuvre in special situations, and a 'balanced' respiratory rate (20-30/min). Individual bedside methods to guide PEEP/recruitment (e.g., transpulmonary pressure) are not (yet) available. Prone positioning [early (a parts per thousand currency sign 48 hrs after onset of severe ARDS) and prolonged (repetition of 16-hr-sessions)] improves survival. An advanced infection management/control includes early diagnosis of bacterial, atypical, viral and fungal specimen (blood culture, bronchoalveolar lavage), and of infection sources by CT scan, followed by administration of broad-spectrum anti-infectives. Neuromuscular blockage (Cisatracurium a parts per thousand currency sign 48 hrs after onset of ARDS), as well as an adequate sedation strategy (score guided) is an important supportive therapy. A negative fluid balance is associated with improved lung function and the use of hemofiltration might be indicated for specific indications. A specific standard of care is required for the management of severe ARDS with refractory hypoxemia."],["dc.identifier.doi","10.1007/s00134-016-4325-4"],["dc.identifier.isi","000374176700012"],["dc.identifier.pmid","27040102"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/14342"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/40778"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.relation.issn","1432-1238"],["dc.relation.issn","0342-4642"],["dc.rights","CC BY-NC 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by-nc/4.0"],["dc.title","The standard of care of patients with ARDS: ventilatory settings and rescue therapies for refractory hypoxemia"],["dc.type","review"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","260"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","Current Opinion in Critical Care"],["dc.bibliographiccitation.lastpage","267"],["dc.bibliographiccitation.volume","17"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Hahn, Guenter"],["dc.contributor.author","Quintel, Michael"],["dc.date.accessioned","2018-11-07T08:55:54Z"],["dc.date.available","2018-11-07T08:55:54Z"],["dc.date.issued","2011"],["dc.description.abstract","Purpose of review Electrical impedance tomography (EIT) is an attractive method of monitoring patients during mechanical ventilation because it can provide a noninvasive continuous image of pulmonary impedance, which indicates the distribution of ventilation. This article will discuss ongoing research on EIT, with a focus on methodological aspects and limitations and novel approaches in terms of pathophysiology, diagnosis and therapeutic advancements. Recent findings EIT enables the detection of regional distribution of alveolar ventilation and, thus, the quantification of local inhomogeneities in lung mechanics. By detecting recruitment and derecruitment, a positive end-expiratory pressure level at which tidal ventilation is relatively homogeneous in all lung regions can be defined. Additionally, different approaches to characterize the temporal local behaviour of lung tissue during ventilation have been proposed, which adds important information. Summary There is growing evidence that supports EIT usage as a bedside measure to individually optimize ventilator settings in critically ill patients in order to prevent ventilator-induced lung injury. A standardization of current approaches to analyse and interpret EIT data is required in order to facilitate the clinical implementation."],["dc.identifier.doi","10.1097/MCC.0b013e3283463c9c"],["dc.identifier.isi","000290040400010"],["dc.identifier.pmid","21478747"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/23016"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Lippincott Williams & Wilkins"],["dc.relation.issn","1531-7072"],["dc.relation.issn","1070-5295"],["dc.title","Lung impedance measurements to monitor alveolar ventilation"],["dc.type","review"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","15"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Respiratory Care"],["dc.bibliographiccitation.lastpage","22"],["dc.bibliographiccitation.volume","61"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Harnisch, Lars-Olav"],["dc.contributor.author","Herrmann, Peter"],["dc.contributor.author","Zippel, Carsten"],["dc.contributor.author","Quintel, Michael"],["dc.date.accessioned","2018-11-07T10:21:44Z"],["dc.date.available","2018-11-07T10:21:44Z"],["dc.date.issued","2016"],["dc.description.abstract","BACKGROUND: During noninvasive ventilation (NIV) of COPD patients, delayed off-cycling of pressure support can cause patient ventilator mismatch and NIV failure. This systematic experimental study analyzes the effects of varying cycling criteria on patient-ventilator interaction. METHODS: A lung simulator with COPD settings was connected to an ICU ventilator via helmet or face mask. Cycling was varied between 10 and 70% of peak inspiratory flow at different breathing frequencies (15 and 30 breaths/min) and pressure support levels (5 and 15 cm H2O) using the ventilator's invasive and NIV mode with and without an applied leakage. RESULTS: Low cycling criteria led to severe expiratory cycle latency. Augmenting off-cycling reduced expiratory cycle latency (P < .001), decreased intrinsic PEEP, and avoided non-supported breaths. Setting cycling to 50% of peak inspiratory flow achieved best synchronization. Overall, using the helmet interface increased expiratory cycle latency in almost all settings (P < .001). Augmenting cycling from 10 to 40% progressively decreased expiratory pressure load (P < .001). NIV mode decreased expiratory cycle latency compared with the invasive mode (P < .001). CONCLUSION: Augmenting the cycling criterion above the default setting (20-30% peak inspiratory flow) improved patient ventilator synchrony in a simulated COPD model. This suggests that an individual approach to cycling should be considered, since interface, level of pressure support, breathing frequency, and leakage influence patient-ventilator interaction and thus need to be considered."],["dc.identifier.doi","10.4187/respcare.04141"],["dc.identifier.isi","000367062300005"],["dc.identifier.pmid","26556898"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/42144"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Daedalus Enterprises Inc"],["dc.relation.issn","1943-3654"],["dc.relation.issn","0020-1324"],["dc.title","Patient-Ventilator Interaction During Noninvasive Ventilation in Simulated COPD"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1615"],["dc.bibliographiccitation.issue","9"],["dc.bibliographiccitation.journal","Intensive Care Medicine"],["dc.bibliographiccitation.lastpage","1623"],["dc.bibliographiccitation.volume","34"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Beck, Jennifer"],["dc.contributor.author","Brander, Lukas"],["dc.contributor.author","Costa, Roberta"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Slutsky, Arthur S."],["dc.contributor.author","Brunet, Fabrice"],["dc.contributor.author","Sinderby, Christer"],["dc.date.accessioned","2018-11-07T11:11:31Z"],["dc.date.available","2018-11-07T11:11:31Z"],["dc.date.issued","2008"],["dc.description.abstract","Objective: Patient-ventilator synchrony during non-invasive pressure support ventilation with the helmet device is often compromised when conventional pneumatic triggering and cycling-off were used. A possible solution to this shortcoming is to replace the pneumatic triggering with neural triggering and cycling-off-using the diaphragm electrical activity (EA(di)). This signal is insensitive to leaks and to the compliance of the ventilator circuit. Design: Randomized, single-blinded, experimental study. Setting: University Hospital. Participants and subjects: Seven healthy human volunteers. Interventions: Pneumatic triggering and cycling-off were compared to neural triggering and cycling-off during NIV delivered with the helmet. Measurements and results: Triggering and cycling-off delays, wasted efforts, and breathing comfort were determined during restricted breathing efforts (< 20% of voluntary maximum EA(di)) with various combinations of pressure support (PSV) (5, 10, 20 cm H2O) and respiratory rates (10, 20, 30 breath/min). During pneumatic triggering and cycling-off, the subject-ventilator synchrony was progressively more impaired with increasing respiratory rate and levels of PSV (p < 0.001). During neural triggering and cycling-off, effect of increasing respiratory rate and levels of PSV on subject-ventilator synchrony was minimal. Breathing comfort was higher during neural triggering than during pneumatic triggering (p < 0.001). Conclusions: The present study demonstrates in healthy subjects that subject-ventilator synchrony, trigger effort, and breathing comfort with a helmet interface are considerably less impaired during increasing levels of PSV and respiratory rates with neural triggering and cycling-off, compared to conventional pneumatic triggering and cycling-off."],["dc.identifier.doi","10.1007/s00134-008-1163-z"],["dc.identifier.isi","000258562800011"],["dc.identifier.pmid","18512045"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?goescholar/3108"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/53454"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.relation.issn","0342-4642"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Subject-ventilator synchrony during neural versus pneumatically triggered non-invasive helmet ventilation"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","543"],["dc.bibliographiccitation.issue","33-34"],["dc.bibliographiccitation.journal","DEUTSCHES ARZTEBLATT INTERNATIONAL"],["dc.bibliographiccitation.lastpage","U50"],["dc.bibliographiccitation.volume","110"],["dc.contributor.author","Weber-Carstens, Steffen"],["dc.contributor.author","Goldmann, Anton"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Kalenka, Armin"],["dc.contributor.author","Kluge, Stefan"],["dc.contributor.author","Peters, Juergen"],["dc.contributor.author","Putensen, Christian"],["dc.contributor.author","Mueller, Thomas"],["dc.contributor.author","Rosseau, Simone"],["dc.contributor.author","Zwissler, Bernhard"],["dc.contributor.author","Moerer, Onnen"],["dc.date.accessioned","2018-11-07T09:21:13Z"],["dc.date.available","2018-11-07T09:21:13Z"],["dc.date.issued","2013"],["dc.description.abstract","Background: During the H1N1 pandemic of 2009 and 2010, the large number of patients with severe respiratory failure due to H1N1 infection strained the capacities of treatment facilities for extracorporeal membrane oxygenation (ECMO) around the world. No data on this topic have yet been published for Germany. Methods: During the pandemic, the German ARDS Network (a task force of the DIVI's respiratory failure section) kept track of the availability of ECMO treatment facilities with a day-to-day, Internet-based capacity assessment. In cooperation with the Robert Koch Institute, epidemiological and clinical data were obtained on all patients treated for influenza in intensive care units. Results: 116 patients were identified who had H1N1 disease and were treated in the intensive care units of 9 university hospitals and 3 other maximum medical care hospitals. 61 of them received ECMO. The overall mortality was 38% (44 of 116 patients); among patients receiving ECMO, the mortality was 54% (33 of 61 patients). The mortality was higher among patients who had an accompanying malignancy or immune deficiency (72.2%). Conclusion: Even persons without any other accompanying disease developed life-threatening respiratory failure as a result of H1N1 infection, and many of these patients needed ECMO. This study reveals for the first time that the mortality of H1N1 infection in Germany is comparable to that in other countries. H1N1 patients with acute respiratory failure had a worse outcome if they also had serious accompanying diseases."],["dc.description.sponsorship","Maquet; Novalung; hemodec"],["dc.identifier.doi","10.3238/arztebl.2013.0543"],["dc.identifier.isi","000326726800001"],["dc.identifier.pmid","24069078"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/29061"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Deutscher Aerzte-verlag Gmbh"],["dc.relation.issn","1866-0452"],["dc.title","Extracorporeal Lung Support in H1N1 Provoked Acute Respiratory Failure The Experience of the German ARDS Network"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]